Severe Anaphylactic Shock with Methylene Blue Instillation

Abstract

In Brief We report a documented severe immunoglobulin E-mediated hypersensitivity reaction associated with use of 1% methylene blue for detection of tubal permeability occurring during general anesthesia. Clinical symptoms, biological assessment results, and cutaneous test positivity confirmed an anaphylactic reaction to methylene blue. This case report confirms the need for systematic allergological investigation of all drugs and substances administered during the perioperative period in the event of a hypersensitivity reaction occurring during anesthesia. Anesthesiologists should be aware of the possibility of hypersensitivity reactions involving any drug or substance used during surgery. IMPLICATIONS: Anaphylaxis involving any drug or substance used during surgery is possible. We diagnosed an anaphylactic reaction resulting from methylene blue instillation used for detection of tubal permeability. The diagnosis was supported by the recognition of clinical symptoms associated with biological assessment and cutaneous tests.